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The bottom-up revolution driving microbiome research at Yale

Fueled by technological breakthroughs and a wealth of information gleaned from private research and government-funded programs, lines of inquiry into human and non-human microbiomes have proliferated in recent years. Robert J. Alpern, MD, dean and Ensign Professor of Medicine, describes the field’s blossoming significance, and how YSM has fostered research in New Haven.

How have attitudes toward the microbiome evolved during your professional career? While in the past, there were interesting observations about the potential importance of the microbiome, today, the microbiome is one of the more exciting frontiers of medicine. While it hasn’t fully defined itself in terms of its importance to homeostasis, or how useful it will be in preventing and treating disease, there’s accumulating evidence that it will be very important to both. “Health” as we think of it may actually be the result of an interplay between our individual genome and the composition of our microbiome and the effects of both on our homeostatic processes, so it’s a vital area of research.

What has the School of Medicine done to prepare for increased activity with the microbiome? First, we’ve recruited outstanding scientists. Second, we’ve built facilities to support those scientists. We’ve staked out a leadership position in this field and ensured that we have a framework to capitalize on what appears to be a likely upcoming boom of investigators (and investigations) into the microbiome. From the standpoint of the school, we want to establish core facilities that allow any researcher, no matter their area of interest, the ability to work with the microbiome.

Was that by design? Yes and no. A number of departments decided to recruit in this area. We agreed to build facilities to support their efforts. I think this is a typical bottom-up success story where departments decided the scientific priorities, the areas they think Yale needed to investigate, and YSM supported those priorities. Then, once the right people were here, and the facilities came online, other people who weren’t necessarily working in the area chose to expand their research.

How has this affected the field of nephrology? The kidney is significantly affected by immunologic diseases, a class of disease that has seen significant correlative overlap with microbiome research. One disease that affects the kidney, IgA nephropathy, involves an antibody that occurs in mucosal interfaces. I wouldn’t be surprised if it turns out that IgA nephropathy was influenced by the microbiome. It’s exciting to be a doctor or researcher at Yale today, with all these longstanding mysteries being resolved—and new questions posed for future scientists!